Individual provider Active NPI

David R Parker Jr., MD

  • Family Medicine Physician
  • Carrollton, TX
National Provider Identifier
1194740597
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H3136 Issued in TX
Practice address
4541 N Josey LN Ste 110
Carrollton, TX 75010-4622
Phone
(469) 788-8588
Fax
(469) 788-7800
NPI assigned
Jul 13, 2006
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H3136 TX Primary
General Practice Physician 208D00000X H3136 TX

Addresses

Primary practice location

4541 N Josey LN Ste 110
Carrollton, TX 75010-4622

Mailing address

4541 N Josey LN Ste 110
Carrollton, TX 75010-4622
Phone (469) 788-8588

Other identifiers 3

IdentifierTypeStateIssuer
118728804MedicaidTX
118728807MedicaidTX
118728802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050831000320 TX Practitioner - Family Practice 8325070238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Little Lantern Clinic LLCGroup PAC ID 0446502322, 2 clinicians

Practice addresses (Care Compare)

4541 N Josey LN
Suite 110
Carrollton, TX 75010-4622
Phone (469) 788-8588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H3136TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Little Lantern Clinic LLC General Practice CurrentSince Oct 27, 2022 Accepting new patients
Physicians and Allied Health Professionals Group, PA Family Medicine Past Accepting new patients

Locations

4541 N Josey Ln
Ste 110
Carrollton, TX 75010
Phone (469) 775-9555

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1194740597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4541 N JOSEY LN STE 110",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104622",
            "telephone_number": "469-788-8588",
            "fax_number": "469-788-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 N JOSEY LN STE 110",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104622",
            "telephone_number": "469-788-8588",
            "fax_number": "469-788-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H3136",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "H3136",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118728804",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118728807",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118728802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

Verify at the official NPI Registry.